TY - JOUR
T1 - The association of overweight, obesity, and long-term obesity with SARS-CoV-2 infection
T2 - a meta-analysis of 9 population-based cohorts from the Netherlands Cohorts Consortium
AU - Lifelines Corona Research initiative
AU - Loef, Bette
AU - Boer, Jolanda M.A.
AU - Beekman, Marian
AU - Campman, Sophie L.
AU - Hoogendijk, Emiel O.
AU - Huider, Floris
AU - Pagen, Demi M.E.
AU - Splinter, Marije J.
AU - van der Velde, Jeroen H.P.M.
AU - Boomsma, Dorret I.
AU - Dagnelie, Pieter C.
AU - van Dongen, Jenny
AU - de Geus, Eco J.C.
AU - Huisman, Martijn
AU - Ikram, M. Arfan
AU - Koster, Annemarie
AU - Licher, Silvan
AU - Mierau, Jochen O.
AU - de Mutsert, Renée
AU - Picavet, H. Susan J.
AU - Rosendaal, Frits R.
AU - Schram, Miranda T.
AU - Slagboom, P. Eline
AU - van der Spoel, Evie
AU - Stronks, Karien
AU - Verschuren, W. M.Monique
AU - van den Berg, Saskia W.
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2025/4
Y1 - 2025/4
N2 - Background: Obesity may affect an individual’s immune response and subsequent risk of infection, such as a SARS-CoV-2 infection. It is less clear whether overweight and long-term obesity also constitute risk factors. We investigated the association between the degree and duration of overweight and obesity and SARS-CoV-2 infection. Methods: We analyzed data from nine prospective population-based cohorts of the Netherlands Cohorts Consortium, with a total of 99,570 participants, following a standardized procedure. Body mass index (BMI) and waist circumference (WC) were assessed two times before the pandemic, with approximately 5 years between measurements. SARS-CoV-2 infection was defined by self-report as a positive PCR or rapid-antigen test or as COVID-19 ascertained by a physician between March 2020 and January 2023. For three cohorts, information on SARS-CoV-2 infection by serology was available. Results were pooled using random-effects meta-analyses and adjusted for age, sex, educational level, and number of SARS-CoV-2 infection measurements. Results: Individuals with overweight (25 ≤ BMI < 30 kg/m2) (odds ratio (OR) = 1.08, 95%-confidence interval (CI) 1.04-1.13) or obesity (BMI ≥ 30 kg/m2) (OR = 1.43, 95%-CI 1.18–1.75) were more likely to report SARS-CoV-2 infection than individuals with a healthy body weight. We observed comparable ORs for abdominal overweight (men: 94 cm≤WC < 102 cm, women: 80 cm≤WC < 88 cm) (OR = 1.09, 95%-CI 1.04–1.14, I2 = 0%) and abdominal obesity (men: WC ≥ 102 cm, women: WC ≥ 88 cm) (OR = 1.24, 95%-CI 0.999–1.55, I2 = 57%). Individuals with obesity long before the pandemic, but with a healthy body weight or overweight just before the pandemic, were not at increased risk. Conclusion: Overweight and obesity were associated with increased risk of SARS-CoV-2 infection with stronger associations for obesity. Individuals with a healthier weight prior to the pandemic but previous obesity did not have an increased risk of SARS-CoV-2, suggesting that weight loss in those with obesity reduces infection risk. These results underline the importance of obesity prevention and weight management for public health.
AB - Background: Obesity may affect an individual’s immune response and subsequent risk of infection, such as a SARS-CoV-2 infection. It is less clear whether overweight and long-term obesity also constitute risk factors. We investigated the association between the degree and duration of overweight and obesity and SARS-CoV-2 infection. Methods: We analyzed data from nine prospective population-based cohorts of the Netherlands Cohorts Consortium, with a total of 99,570 participants, following a standardized procedure. Body mass index (BMI) and waist circumference (WC) were assessed two times before the pandemic, with approximately 5 years between measurements. SARS-CoV-2 infection was defined by self-report as a positive PCR or rapid-antigen test or as COVID-19 ascertained by a physician between March 2020 and January 2023. For three cohorts, information on SARS-CoV-2 infection by serology was available. Results were pooled using random-effects meta-analyses and adjusted for age, sex, educational level, and number of SARS-CoV-2 infection measurements. Results: Individuals with overweight (25 ≤ BMI < 30 kg/m2) (odds ratio (OR) = 1.08, 95%-confidence interval (CI) 1.04-1.13) or obesity (BMI ≥ 30 kg/m2) (OR = 1.43, 95%-CI 1.18–1.75) were more likely to report SARS-CoV-2 infection than individuals with a healthy body weight. We observed comparable ORs for abdominal overweight (men: 94 cm≤WC < 102 cm, women: 80 cm≤WC < 88 cm) (OR = 1.09, 95%-CI 1.04–1.14, I2 = 0%) and abdominal obesity (men: WC ≥ 102 cm, women: WC ≥ 88 cm) (OR = 1.24, 95%-CI 0.999–1.55, I2 = 57%). Individuals with obesity long before the pandemic, but with a healthy body weight or overweight just before the pandemic, were not at increased risk. Conclusion: Overweight and obesity were associated with increased risk of SARS-CoV-2 infection with stronger associations for obesity. Individuals with a healthier weight prior to the pandemic but previous obesity did not have an increased risk of SARS-CoV-2, suggesting that weight loss in those with obesity reduces infection risk. These results underline the importance of obesity prevention and weight management for public health.
UR - http://www.scopus.com/inward/record.url?scp=85208052034&partnerID=8YFLogxK
U2 - 10.1038/s41366-024-01660-x
DO - 10.1038/s41366-024-01660-x
M3 - Article
AN - SCOPUS:85208052034
SN - 0307-0565
VL - 49
SP - 586
EP - 595
JO - International Journal of Obesity
JF - International Journal of Obesity
ER -